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    What Can a Canadian Pharmacy Do About the Addiction and Overdose Crisis

    by Skye Sherman - October 9 , 2018


    Photo Credit: by Philippa Willitts, flickr.com
    Photo Credit: by Philippa Willitts, flickr.com

    With all the recent media coverage about America’s opioid crisis (especially in Florida)--which begins in most cases with a prescription for strong pain killers and blossoms into dependency and worse--overdose awareness has become an increasingly more important topic to discuss. Though overdose is a common method of suicide, which must be addressed with mental health initiatives, there are also a sizable number of accidental overdoses. Overdoses are completely preventable and should never be a cause of death, especially unintentionally. It’s imperative that people further their education about prescription drugs and become aware of what is safe to consume and what is not.

    Opioids and fentanyl, which is a deadly synthetic painkiller that is 50 to 100 times stronger than morphine, are the main drivers behind this crisis. What are opioids, exactly? They are narcotics that act on our body’s opioid receptors to produce morphine-like effects; in short, medically, they are primarily used for pain relief (including anesthesia). This class of prescription drugs includes heroin (which is illegal), synthetic opioids (such as fentanyl), and pain relievers that are available legally by prescription (such as oxycodone or OxyContin®, hydrocodone or Vicodin®, codeine, morphine, etc.). Unfortunately, use and abuse of even legal prescription substances often lead addicts to turn to even harder drugs such as heroin, which is an extremely powerful and lethal drug that is far too easy to overdose on.

    The overdose crisis is at an all-time high, which makes overdose prevention efforts all the more important. Did you know that nearly 100 Americans die every day from overdosing on opioids and prescription drugs? Or that overdose rates are highest among people between the ages of 25 and 54? Our younger generations are robbing themselves of the chance to lead long lives and fulfill their highest potential. So what’s behind this, and what can we do about it?

    Above all, as a patient, please remember: if you have any doubt in your mind whatsoever about a drug or want to have a clear understanding of what is safe and what is not when it comes to prescription medications or any other substance, you should contact a medical professional without delay. Seeking the advice and counsel of a licensed medical doctor is of paramount importance. This is not somewhere you want to take chances or risks or play the guessing game. Before taking any medication, you must first talk with your doctor extensively about potential side effects, safe dosage practices, your health history, risks, and options.

    In this article, we’ll address the overdose crisis head-on with the aim of increasing overdose awareness in an effort to end overdose related deaths.

    Who is at risk of overdosing?

    Unfortunately, the risk of overdose is not limited to just those struggling with drug addiction; it spreads to anyone who comes into contact with potentially addictive drugs or anyone who is uninformed about safe dosing practices for any and all medications. This includes teenagers, elderly people, and more.

    Stories of accidental overdoses by teens are some of the most heartbreaking. These young people have their entire lives ahead of them and they should be protected from such risks. One family shares the story of their 16-year-old son Elliot, who died of an unintentional drug overdose. The parents say they “felt trapped by a medical system that didn’t give them a say in their son’s painkiller prescriptions.”

    After enduring four surgical procedures for two different sports injuries, doctors put Elliot on opioids against the wishes of his parents. Following the young boy’s death, his mother shared on Facebook, “Elliot was prescribed opioids around every surgery even though, as parents, we requested alternatives. Elliot was back in the hospital for 3 weeks in February with a severe infection where again opioids were used for pain management. Elliot, being 16, was given full autonomy by the Health Care system to make his treatment decisions while specifically having my Husband and I excluded from this information ... this policy needs to be changed. Parents need a say in their child’s health care. The rest of the story is textbook for this sad and preventable ending.”

    Stories of teen overdose point out how important it is for the discussion around the power of opioids to be covered in more depth with patients and their families alike. Children do not have enough experience in the world yet to understand the consequences or severity of their actions in many cases, which is why it’s important that the education efforts around this topic increase.

    Another demographic is at particular risk of accidental overdose. Elderly people are commonly over prescribed medications and in addition, can accidentally take too much because their bodies simply don’t metabolize and process these chemicals in the same way that younger people do.

    According to a news report by ABC 33 40, “An unintentional overdose can happen to anyone at any age. However, seniors are especially vulnerable. Physicians who specialize in geriatric care warn over-the-counter medications pose a threat for a number of reasons. The simple answer is an older body just doesn’t process chemicals the way a younger body does. So even when medications are taken as directed, they can still pose a health risk. Pair an over-the-counter product with prescription medications, and the results can be dangerous.”

    Many elderly people live with a chronic health condition of some sort and take medication to counteract or treat it. Thus, they have a greater likelihood of being exposed to the risks that their medications carry.

    Common over the counter medications involved in overdoses

    Believe it or not, even over the counter medications can put people at risk of an overdose. Just because something is common and safe in small quantities--such as household medicines like Advil, Tylenol, or Benadryl--does not mean that it carries no risk. In fact, it is safe to assume that too much of anything can prove deadly if taken in excessive quantities, even something as harmless as water. Sleeping pills are also a drug that carries a high risk for dependency, misuse, and overdosing.

    Instead of sharing what over the counter medications are typically involved in overdoses, as we do not want this information to be used for the wrong purposes, we will simply state here that you should never take more than the prescribed or recommended dose that appears on the bottle or at the advice of your doctor. Always look up drug interactions and be aware of what a safe, normal dose of any medication should be. If you feel you are taking too much or are not sure how much is too much, contact a professional immediately for advice or help if you need it.

    Common prescription drugs involved in overdoses

    Although people can overdose on nearly any drug out there, prescription medications are a common culprit, especially painkillers and narcotics. Most prescription painkillers come with some degree of risk of dependence. No matter how bad a person’s pain level is, these medications should be handled with care and treated like the serious risks that they are. Though these medications can be prescribed for legitimate reasons, it is vital that patients are made aware of their addictive potential.

    Both opioids and other prescription medications are commonly present in cases of overdose. According to Medical News Today, “When deaths from overdoses from opioid painkillers occur, there are usually other prescription medications for mental health disorders and/or neurologic conditions involved too, researchers from the Centers for Disease Control and Prevention (CDC) reported in JAMA (Journal of the American Medical Association). The authors had gathered and analyzed CDC data involving deaths from overdosing on opioid painkillers. They found that in 30.1% of deaths, patients had also taken benzodiazepines.

    Benzodiazepines are popular psychiatric prescription medications, and include such names as Ativan (lorazepam), Klonopin (clonazepam), Xanax (alprazolam) or Valium (diazepam). They are commonly prescribed for anxiety problems, as sedatives, and anticonvulsants (for epilepsy). Benzodiazepines are also muscle relaxants. …

    Of the pharmaceutical-related deaths from overdose, 74.3% were unintentional and 17.1% were intentional (suicides), while 8.4% were of ‘undetermined intent.’

    Among deaths caused by prescription drugs, the most commonly found medications (either in combination or on their own) were:

    * 75.2% - opioids

    * 29.4% - enzodiazepines

    * 17.6% - antidepressants

    * 7.8% - drugs used for epilepsy and Parkinson’s disease

    [In addition,] opioids [are] present in many deaths involving other drugs. … In November 2011, the CDC reported that more Americans died from prescription painkiller overdoses than all deaths from cocaine and heroin combined.”

    This information demonstrates that although opioids are commonly involved in overdose deaths, they do not always work alone. Doctors should prescribe these powerful drugs with caution, and patients should be fully aware of the risks and have a plan for managing their drug treatment safely if they decide to use these classes of drugs.

    Monitoring programs to prevent overdose

    How serious, exactly, is the opioid epidemic? What are the far reaching implications? Is it really that important to have programs in place that help to prevent overdose?

    Take this information recently published in STAT for a picture of just how dire the situation is in America today. “According to the CDC, the average life expectancy at birth in the U.S. fell by 0.1 years, to 78.6, in 2016, following a similar drop in 2015. This is the first time in 50 years that life expectancy has fallen for two years running. In 25 other developed countries, life expectancy in 2015 averaged 81.8 years.

    There’s no question that a big culprit is the opioid epidemic, which contributed significantly to an increase in death rates for Americans aged 15 to 64 years. … With 4 percent of the world’s population, the U.S. accounts for 27 percent of the world’s overdose deaths.”

    Cleary, the overdose crisis is a major issue plaguing American society. That’s why programs to prevent or end overdose are so important. Some states have introduced prescription drug monitoring programs (also known by the acronym PDMPs) that are intended to deter the overprescription of opioids as well as their misuse and abuse. Some studies seem to suggest that PDMPs lower fatal opioid overdoses, but others show an increase in heroin overdose deaths after PDMPs are implemented.

    So, currently the jury is out, and it remains to be seen what the long term results of PDMP programs are. It is crucial that we continue to look for better and more effective solutions that will help them the overflow of prescription overdoses.

    Marijuana’s role in combating the drug misuse and overdose epidemic

    Interestingly enough, recent years have seen the rise of a natural plant to help combat the overdose epidemic. This is because the use of marijuana can replace the need for opioids for many people, and in most cases, it is safer and does not pose the same risk of dependence or addiction.

    NORML, an organization working to reform marijuana laws, states, “Evidence informs us that medical marijuana access is associated with reduced levels of opioid-related abuse, hospitalization and mortality. … For many patients, cannabis offers a viable alternative to opioids. It is time for lawmakers to stop placing political ideology above the health and safety of the American public, and to acknowledge the safety and efficacy of marijuana as an alternative medical treatment.”

    If more people turn to marijuana instead of powerful prescription painkillers, it is likely that instances of accidental addiction and overdose will see an overall decrease.

    How do we help combat the overdose crisis?

    Here at Canadian Pharmacy World, we do our part to help combat the overdose crisis by requiring a legitimate prescription from a doctor before dispensing medications of any sort. We are also an accredited pharmacy that offers patients the chance to purchase low cost medications in a safe and reliable way. We monitor orders and are aware of best practices in order to stand against the potential for misuse of prescription drugs.

    Canadian Pharmacy World is a CIPA member and a Certified Canadian International Pharmacy. Moreover, we are proud to participate in a program that requires its members to adhere to exceptional quality standards and all regulatory requirements in the country of the dispensing pharmacy. We only use dispensaries or affiliate pharmacies that have also been CIPA inspected. We are also a PharmacyChecker verified pharmacy, so you can feel good about purchasing from us.

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